MARVIN MANDEL, Governor

1391

(D)       CONTRACTING WITH ANY PERSON FOR THE
PERFORMANCE ON ITS BEHALF OF CERTAIN HEALTH CARE PLAN
FUNCTIONS, SUCH AS MARKETING, ENROLLMENT, AND
ADMINISTRATION;

(E)     CONTRACTING WITH AN INSURANCE COMPANY OR
COMPANIES LICENSED TO DO AN ACCIDENT AND HEALTH BUSINESS
IN THE STATE OR WITH ANY HOSPITAL, NONPROFIT HEALTH
SERVICE PLAN, MEDICAL HEALTH SERVICE, NURSING SERVICE,
OPTOMETRIC SERVICE, PODIATRY SERVICE, DENTAL SERVICE, OR
PHARMACEUTICAL SERVICE PLAN CORPORATION, OR ANY SIMILAR
ENTITY AUTHORIZED TO DO BUSINESS IN THIS STATE, FOR THE
PROVISION OF INSURANCE, REINSURANCE, OR INDEMNITY, OR
REIMBURSEMENT AGAINST THE COST OF HEALTH CARE SERVICES
PROVIDED BY THE HEALTH MAINTENANCE ORGANIZATION;

(F)     RECEIVING AND ACCEPTING FROM GOVERNMENTAL OR
PRIVATE AGENCIES PAYMENTS COVERING ALL OR PART OF THE
COST OF SUBSCRIPTIONS TO PROVIDE HEALTH CARE SERVICES,
FACILITIES, APPLIANCES, MEDICINES, AND SUPPLIES;

(G)    PURCHASING, LEASING, CONSTRUCTING, RENOVATING,
OPERATING, OR MAINTAINING HOSPITALS, MEDICAL FACILITIES,
OR BOTH, AND THEIR ANCILLARY EQUIPMENT, AND PROPERTY
REASONABLY REQUIRED FOR ITS PRINCIPAL OFFICE OR FOR OTHER
PURPOSES NECESSARY IN THE TRANSACTION OF THE BUSINESS OF
THE ORGANIZATION; AND

(H) OFFERING, IN ADDITION TO HEALTH CARE SERVICES,
INDEMNITY BENEFITS COVERING OUT-OF-AREA AND EMERGENCY
SERVICES.

846.

(A)    ANY MARKETING DOCUMENT PURPORTING TO ENUMERATE
THE ORGANIZATION'S HEALTH CARE SERVICES SHALL CONTAIN
CLEAR AND COMPLETE INFORMATION DESCRIBING:

(1)     THE HEALTH CARE SERVICES UNDER EACH
HEALTH CARE PLAN AND ANY OTHER BENEFITS TO WHICH THE
MEMBER IS ENTITLED;

(2)    WHERE AND IN WHAT MANNER SERVICES MAY BE
OBTAINED; AND

(3)     ANY EXCLUSIONS OR ANY LIMITATIONS ON
SERVICES OR ANY OTHER BENEFITS TO BE PROVIDED, INCLUDING
ANY DEDUCTIBLE OR CO-PAYMENT FEATURE.

(B)     ANY APPLICATION OR OFFER OF ENROLLMENT SHALL
INCLUDE OR BE ACCOMPANIED BY, AND ANY FORM OF SUBSCRIBER
CONTRACT SHALL CONTAIN, CLEAR AND COMPLETE INFORMATION
CONCERNING THE ITEMS SPECIFIED IN SUBSECTION (A) OF THIS
SECTION AS WELL AS THE FOLLOWING: